Public perceptions on robotic surgery, hospitals with robots, and surgeons that use them.

Objective: The use of robotic-assisted surgery (RS) has rapidly increased, but public perceptions about RS are largely unknown. The aim of this study was to gain insight into public perceptions about RS, hospitals that have robots, and surgeons that use them.

Methods: A Web-based survey was distributed worldwide.

New technologies for promoting a healthy diet and active living.

Information and communication technologies (ICT) offer innovative formats for promoting healthy lifestyles and reinforcing public health initiatives. They can be applied to large population segments without losing the functionality of being tailored to individual fluctuating needs. Advantages of ICT include real-time provision and adaptation of nutrition and health recommendations based on an individual's particular situation, the potential to combine assessment procedures with healthy lifestyle support and the ability to unify psychosocial and cultural dimensions to enhance adherence.

Cultural aspects of information technology implementation.

Culture sets our values and norms. It is a way of thinking that determines our behaviours, decisions, actions and knowledge. Technology transfer and integration are basically the exchange of the knowledge, know-how and skills through which technology was created and on which its use depends.

The future is no longer what it used to be. Managing health telematics projects.

Future used to mean global progress and convergence of science and technology and society. Today, we observe the decoupling of the two poles of knowledge formation and application (i.e.

Healthcare Information Framework.

CEN committee TC 251 Medical Informatics, has set up a project team charged with producing a European pre-standard ENV on Healthcare Information Framework (HIF). The HIF is based on abstraction from a specific information system architecture to a reference architecture and further to a conceptual architectural framework based on serving open, distributed and heterogeneous healthcare enterprises. To specify the suitable healthcare information system architecture modelling of the healthcare enterprise is required.

Integration architecture: the ISAR project.

ISAR (Integration System Architecture) will integrate six AIM Projects on the HIS platform at the University Hospital (CHRU) of LILLE. These Projects were elicited from six European consortiums that provided prototypes or pre-competitive products. These consortia are: ESTEEM (storage and analysis of electromyograms), EURIPACS (picture archiving and communication system), MENELAS (analysis of the natural language for medical applications), OEDIPE (storage and serial analysis of electrocardiograms), OPADE (help with drug prescription), and TANIT (mobile system for anaesthesia).

KAVAS-2: Knowledge Acquisition, Visualization and Assessment System.

The objective of KAVAS-2 is the development of a tool, named KAVIAR, with which domain experts can make their knowledge explicit. It contains components for (computer assisted) knowledge elicitation and for machine learning. A key issue in KAVAS is the assessment of the quality of the classification and domain models built.

Information transfer in high dependency environments: an ergonomic analysis.

We have studied the information flow in HDE (with special focus on the information transfer process) using data provided by a group of experienced health care professionals. A model of the information flow in HDE was built up. It postulates the existence of quanta of information (due to the artificial fragmentation of the information flow produced by the clinical working processes: organization in shifts, demand of simultaneous activities from different staff members, etc.

Turning the mass-spectrometer into an easy to handle clinical instrument for routine multipatient surveillance of respiratory and anesthetic gases during anesthesia.

Although most authors use it as the reference instrument for respiratory gases measurement, the use of mass-spectrometer in clinical routine in ICU and in anesthesia remains quite limited. We developed a fully automatically controlled system, carrying on a twinned goal: The ACS-2000 (Automatic Calibration System) turns the Airspec MGA-2000 mass-spectrometer into a true clinical instrument, as easy to use as any routine monitoring instrument, and lets the clinician and the anesthetist benefit from its uncomparable metrological performances. PAMS-M, multibed monitoring system, shares the mass-spectrometer time among 4 to 8 rooms, providing each anesthetist with full composition of inspired and end tidal gases composition, trend evolution of those data, as with the display of capnogram.

Assessment of the performance of electrocardiographic computer programs with the use of a reference data base.

To allow an exchange of measurements and criteria between different electrocardiographic (ECG) computer programs, an international cooperative project has been initiated aimed at standardization of computer-derived ECG measurements. To this end an ECG reference library of 250 ECGs with selected abnormalities was established and a comprehensive reviewing scheme was devised for the visual determination of the onsets and offsets of P, QRS, and T waves. This task was performed by a group of cardiologists on highly amplified, selected complexes from the library of ECGs.

Real time mathematical analysis of instantaneous respiratory signals at the bedside by a multiprocessor system (PAMS).

The authors address the following problems: How to turn a mass spectrometer, or a set of individual gas sensors, into a real and useful medical instrument? In other words, how to transform the instantaneous gas composition signals into meaningful physiological variables? The parameters that can be computed breath by breath from the real time processing of gas concentration signals, combined with flow and pressure signals at the mouth are first described. Particularly, we point out the theoretical and practical importance of alveolo-capillary gas exchange parameters, as opposed to gas exchange parameters estimated at the mouth level: A-c exchange parameters are a more sensitive and more specific indicator of any physiological change and they are less sensitive to breath by breath fluctuations of ventilation. We discuss the clinical usefulness of breath by breath computations, as a more sensitive way to monitor the patient as well as the anesthesia circuit, and to generate all the information required for on line analysis of functional tests.

Continuous monitoring by microprocessor from the operating room to the intensive care unit.

The "Chronicler" is made up of a microcomputer (the CPU is a Motorola 6809), an alphanumeric-graphic display with keyboard and a printer. The system is connected to several physiological signal monitors and in our application to a mechanical ventilator under electronic control. It collects every 5 seconds - or at each breathing cycle if required - all the data supplied by the various measuring devices including those in the mechanical ventilator.

Ventilation in dogs on cardiopulmonary bypass with and without lungs.

In 13 anesthetized or awake dogs, on cardiopulmonary bypass, we varied PaO2 and PaCO2 while continuously monitoring ventilatory responses and mechanics, to assess the dog's ability to maintain eupneic ventilation for any chemical drive. In a second group of 13 dogs on cardiopulmonary bypass we repeated the tests after removal of both lungs, to assess the importance of pulmonary feedback and mechanics. The VE/PO2 plot formed two hyperbolas, asymptotic to 39 Torr PO2 with lungs, and to 27 without; both intercepted zero ventilation near 200 Torr.

A multi-sensor support for in vivo monitoring of blood parameters with in situ sensor calibration.

An apparatus permitting continuous simultaneous in vivo monitoring of human arterial blood parameters is described. Sensors are held firmly in position in arterial blood flowing through an extracorporeal shunt. The system is reliable, rugged and inexpensive.

Continuous in vivo measurement of arterial PO2 in humans.

A system suitable for prolonged continuous in vivo measurement of human arterial PO2 is described. The system uses a polarographic electrode developed by Kimmich and Kreuzer, inserted in a specially made shunt between the radial artery and an antecubital vein. Nhe electrode surface is maintained in a fixed position parallel to the flow of blood; blood velocity dependency is small owing to the high flow rate achieved (more than 40 cm/s); clotting is prevented by the material used and the continuous instillation of heparin through the arterial end of the shunt.

Monitoring respiratory function by computer in ICU. Preliminary work.

The structure of the respiratory monitoring system under construction in Brussels University Hospitals is described. It is modular and hierarchized. It is based on the observation of the lung mechanics, of the flows of inspired and expired gases and of continuous blood measurements in patients artificially ventilated.